Tot grote vreugde van skateboarders wereldwijd zijn er deze week fantastische outtakes opgedoken uit de film Dogtown and Z-Boys. Let vooral op de concentratie op het gezicht bij de laatste move.

In honor of Red and Blue Day, what follows is a reprint of an article I wrote for the November 2009 issue of The Right Heart Times, the newsletter of the CHD support group Hypoplastic Right Hearts:

The Blalock-Taussig Shunt (Shunt means “detour”) was the brainchild of one of the most unusual people in medicine: Dr. Helen Taussig. Despite being Dyslexic and slowly losing her hearing after becoming a doctor, Taussig had overcome both disabilities to become the head of the Cardiac unit at the Harriet Lane Home for Invalid Children, located at Johns Hopkins Hospital in Baltimore, Maryland.

While at Harriet Lane she began to study Congenital Heart Defects, especially Tetralogy of Fallot (ToF). ToF children suffered from a combination of four heart defects which led to the mixing of oxygenated blood with unoxygenated blood inside their damaged hearts. This caused them to have Cyanosis (have a bluish tinge to their skin due to poor blood oxygenation), have poor stamina, difficulty feeding and usually die before they reached ten years old.  Despite the fact that these children were breathing hard and deep, they were suffocating – and there was nothing that Dr. Taussig could do about it.

Taussig’s frustration would continue until 1943, when Hopkins hired Dr. Alfred Blalock as the new Chief of Surgery. It wasn’t long after his arrival that Taussig and Blalock had a conversation that would change the world.

Hopkins legend states that Dr. Taussig literally broke into a conversation between Dr. Blalock and her boss, Dr. Edwards Park, and convinced him to attempt a surgical repair of the defect. Blalock reminded her that it was impossible to operate on the heart (at that time it was impossible) but Taussig contended that what she had in mind was not an operation on the heart itself, but moving the blood vessels around to send more blood to the lungs. She had the idea, but since she was not a surgeon she could not act on it.

Little did she know that he already had a partial answer. While studying the effects of shock on the human body, Blalock and his assistant Vivien Thomas had sewn a smaller artery onto the Pulmonary Artery in an attempt to increase blood pressure. Blood pressure had not been affected, but blood flow increased. The challenge now was to recreate the effects of ToF in a dog, perform the arterial connection, and evaluate the results. Swamped with his teaching duties and surgical schedule, Blalock turned the assignment almost completely over to Thomas. An African American with a high school education, Thomas had gotten a job in Blalock’s lab after dropping out of college and had become Blalock’s most able assistant.

Re-creating either the heart defect or the planned repair often proved fatal for the dog, but finally Thomas found the perfect combination and a mutt named Anna survived. The next step was to teach Blalock the procedure. The surgeon had observed the operation several times but had never done it himself; Thomas had done the procedure several hundred times – all on dogs.

On November 29, 1944, the trio tried the new surgery. They may have operated sooner than they wanted to, but young Eileen Saxon’s condition was deteriorating. Although she was 15 months of age, Eileen weighed only nine pounds and was badly cyanotic.

As they were preparing for surgery, Blalock turned to his scrub nurse and quietly asked her to summon Mr. Thomas. Although Thomas had taught him the procedure, he wanted his assistant close by in case there was a problem. Thomas entered the surgical suite and stood behind Blalock, guiding him through the operation and giving advice.

Making a five-inch incision on Eileen’s left side, Blalock clamped and cut her Left Subclavian Artery. The Left Subclavian branches off of the Aorta, travels along the shoulder blade (the Clavicle) and down the left arm. For a visual reference, the Left Subclavian Artery is located almost directly behind a police officer’s badge.
Blalock then placed clamps on the left branch of the Pulmonary Artery and made a small hole in the artery. Gently pulling the Subclavian downward, Blalock sewed the vessel onto the Pulmonary Artery, took a deep breath, and disconnected the clamps.

Eileen’s cyanosis almost instantly faded. “She’s a lovely color now!” Taussig exclaimed. Blalock’s surgical notes are a bit more understated, reporting that “the circulation in the nail beds of the left hand appeared to be fairly good at the completion of the operation.”

Originally known as a “subclavian to pulmonary anastomosis,”the operation was soon renamed the Blalock-Taussig Shunt, after the surgeon who performed it and the doctor who conceived it. Thomas received almost no credit for his part of the procedure during his lifetime.

Survivors of the Blalock-Taussig Shunt often have difficulty getting a pulse or a blood pressure reading in the arm on the shunt side (because of the disconnected Subclavian Artery) and should avoid having injections into that arm. In the late 1970’s the Modified Blalock-Taussig Shunt (MBTS) became popular. The MBTS leaves the Subclavian intact and makes the Subclavian-Pulmonary connection by inserting an artificial tube and avoids the arm problems created by the original Blalock-Taussig.
Eileen Saxon did well for a few months but again became Cyanotic as her shunt failed. She underwent another Blalock-Taussig Shunt (on her right side this time) but passed away just before her third birthday.

Blalock’s surgical team performed almost 200 Shunts in the space of a single calendar year and the operation opened the door for Congenital Cardiac Surgery. He continued to operate until just before his retirement in 1964, and died six months later.

Dr. Helen Taussig became known as “the Mother of Pediatric Cardiology” and had a part in averting the Thalidomide crisis in the early 1960’s. She retired in 1963 but often returned to Hopkins, staying current on the latest Cardiac research and contributing  much of it herself. She was killed in an automobile accident in May of 1986.

Vivien Thomas continued to stand at Blalock’s shoulder and eventually became Director of the Johns Hopkins Hospital Surgical Research Laboratories. He trained many of the surgeons who would become famous for their heart surgery accomplishments and invented many of the procedures that they would use. He received an honorary doctorate in 1976 and retired in 1979. Thomas wrote his autobiography, Partners of the Heart: Vivien Thomas and his work with Alfred Blalock and died in 1985, just before the book was published.

Anna the Dog served as the mascot of the Johns Hopkins Surgical Labs until her death in 1957.

De titel zegt alles.

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Ik moet duidelijk meer internetten, want tegenwoordig is zelfs De Wereld Draait Door me te snel af met de nieuwste hypes.

Meer Kabouter Wesley.

Ik vond de pokkie foetsie campagne van Hi vrij matig, maar dit is een prachtige viral.

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A time of flight (ToF) camera is one option we have looked at as a possible technology to use in this project. The cameras work on the principle of emitting a beam or stream from a source and measuring how long it takes for this beam to be detected at a receiver (the camera). This can result in a very high quality digital image being produced that can decipher depth of objects to an impressive accuracy.

Time of flight technology has a wide variety of uses in Industry and has recently been used in the area of multimedia. It is also used in the area of Mass Spectrometry for detecting impurities in pharmaceuticals and identifying proteins.   ToF technology has been used to measure long distances and to discover the thickness of certain materials in Industry. However, the reason the technology is of interest to our project is in the ToF camera’s ability to detect objects or obstacles.

The ToF camera gives a purely digital view of the surroundings and could be used to give a 3D view of the world to the user or communicating digital device. The image received could then be analysed and potential obstacles could be detected and a warning given out to the user to avoid a collision or accident. It has already been shown that ToF technology can be used to identify objects in great detail.

Advantages of the time of flight 3D camera compared to a similar obstacle detector like a IR laser sensor or Ultrasonic sensor is if we were to use a time of flight camera we would not be subject to the limitations faced by these other types. Ultrasonic sensors have a tendency to malfunction when tested in snow or rain, the ultrasound emitted bouncing off of rain droplets and being interpreted by the receiver as a close object. The ToF could possibly eliminate this shortcoming with its ability to receive a picture of its entire surroundings – small pixellated errors like rain could be ignored for the bigger picture.

Shortcomings of the 3D camera come in the form of cost and practicality. With the nature of the project (we need a small, light device with low voltage requirements) there is a trade-off between price, size and power consumption. Most time of flight sensors are bulky and unusable for this  type of application and ones that are small enough are either too expensive or too costly on power or both. Models like the one shown in the video above are much too expensive to be used in the area we are targeting.

Een filmpje van Sergej Hein.

Een mondharmonica is fout. Een mondharp ronduit verwerpelijk. Maar deze gozer speelt mondgitaar, en dan nog zonder instrument. Ok, met een beetje hulp van een versterker dan. In ieder geval is het supertof. Het maakt me niet eens uit of dit echt is, dit filmpje maakte mijn avond.

Op een dag kom ik hard met mijn hiphopproject als CM Dyslexia. Te zijner tijd zal de mixtape Straight Outta Lombok de straten versteld doen staan. Maar voorlopig moet je het doen met geestverwanten als het WTF Collective, oftewel Jon Layoie. Met bazen als MC Insecure, MC Amnesia en MC Public Urination. Gelukkig heeft ie het copyright op mijn alias niet geschonden.

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Nog maar eens een geslaagde reclame. Met iets minder design dan in nummer 22 van gisteren, maar daarom niet minder genialiteit.

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De New York Times is er nu ook in het Turks, en daar moet natuurlijk reclame voor worden gemaakt. Teşekkürler voor een prachtig promotiefilmpje.

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Een keer trek je de conclusie, balletje balletje is een illusie.

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She didn’t even have a name for it.

When Dr. Helen Taussig wrote Congenital Malformations of the Heart in 1947, she described one malformation as “Atresia or marked hypoplasia of the aortic orifice prevents the expulsion of blood from the left ventricle in the normal manner.” Taussig described several variations of the defect – actually different defects, later grouped together under the same deadly name – but could offer no treatment suggestions. Her Tetralogy of Fallot (ToF) patients could at least squat and get some temporary relief; children cursed with this malady died in less than one week. The left side of the heart wasn’t damaged as much as it just wasn’t there.

It wasn’t until 1958 that Dr. Jacqueline Noonan and Dr. Alexander Nadas named the group of defects Hypoplastic Left Heart Syndrome (HLHS). Hypoplastic comes from the root word hypoplasia, which means “small”.

But having a name for it didn’t make it any less deadly as HLHS continued to claim 100% of its victims. This sad story continued until 1985, when the first successful infant heart transplant took place.

At about the same time the Norwood Procedure was developed. Originally designed as one operation (which consistently failed) the procedure was soon split into two heart operations – and eventually three – which seemed to work. HLHS children now had a chance. Obviously long term survival rates aren’t known yet, but approximately 70% survive the three surgery protocol.

And thats when the dirty little secret of HLHS showed itself: While survival rates for the three operation procedure may be in the 70% range, getting from Stage I to Stage II is the hardest step.

The goal of the Stage I operation is to make the Right Ventricle do the job of the defective Left Ventricle – getting the blood to the body. With all of the blood flowing through the right side of the heart, that side is subject to higher flow pressures than it usually receives. A lot higher. In a defect in which the entire left side of the heart is damaged, a successful outcome usually depends on the Tricuspid Valve – located on the right side of the heart.

The inital results were confusing. The Norwood worked – then it didn’t. There didn’t seem to be any rhyme or reason to it, no way to predict outcomes. The surgery itself worked, but too often the results  seemed to be as random as a roll of the dice. The answer was the Sano Shunt, invented by Japanese surgeon Shunji Sano – a direct connection from the Right Ventricle to the Pulmonary Artery through a Gortex conduit. (this sounds redundant, but the Pulmonary Artery is normally disconnected from the ventricle in the Stage I operation). Studies showed that survival chances with the Modified Norwood was 11 times greater than with the Classic Norwood.

And now it is time to turn the tables – we’ve got a nasty little trick of our own. Heart defects have to start somewhere… at some point in fetal development, there must be one isolated problem that seems to “snowball” into something bigger as time passes. If we could find that one little problem and repair it then, maybe we can stop the snowball before it gets too big. A pretty cool idea, and maybe one day…

Someday…

A study released Monday (September 28, 2009) revealed that for seven years, doctors at several hospitals in Boston and Harvard Medical School have been detecting Aortic Stenosis in fetuses. Fetal Aortic Stenosis is a snowball; it usually becomes HLHS as the fetus develops.

70 future HLHS patients underwent surgery while still in the womb – a needle was inserted into the mother’s abdomen, passed into the fetus, and into the heart of the unborn child. A small balloon was used to enlarge the abnormally small Aortic Valve. 51 of the procedures were considered successful… and 30% (17 children of the 51) were born with two functional ventricles. That’s 17 children who won’t have HLHS.

Mark September 28  on your calendar… that was the day that the CHD world changed forever.

Lady Gaga geëlektrocuteerd tijdens een optreden. Ik vind hem heel heel grappig.

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Toch is het meer ‘come in’ dan ‘go away’.

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Dit is geweldig.

Dat is héél knap gedaan!

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Het voetbalseizoen staat weer op het punt van beginnen. Ikzelf heb de eerste officiële training zelfs alweer achter de rug. De FA weet in deze spoof op een oude Nike-reclame het onderbondgevoel perfect weer te geven. En een pluspunt ten opzichte van het origineel: geen latente Portugese crybabies.

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There is new research into the causes of Tetralogy of Fallot (ToF), focusing on the genetic makeup of ToF hearts.

“Tetralogy” means “four parts,”  and ToF is a combination of four separate problems : a Ventricular Septal Defect (VSD);  Pulmonary Stenosis; an Overriding Aorta; and an extremely muscular Right Ventricle. (Here’s a diagram)

ToF accounts for about 10% of all heart defects, and was the defect that the Blalock-Taussig Shunt was designed to relieve. The B-T Shunt was a palliative measure, meaning that instead of curing the defect, it was meant to relieve it. Even today there is no cure for Tetralogy of Fallot, although it can be surgically repaired.

ToF has always been a puzzling defect because the parents of a Tet child usually have no cardiac issues. Recent research only deepened the mystery as it seems that there is no genetic predisposition, either. ToF seems to “pop up” when it wants to.

Scientists at the Howard Hughes Medical Institute have recently found some clues into the genetic makeup of  the defect. After scouring the DNA of 114 Fallot patients, they have found 11 segments that might lead to the occurrence of Tetralogy of Fallot. They are so small that if you put all these DNA segments together, you can’t see them.

Technically these segments are known as copy number variations. The segments control how much protein is produced by a cell, and the variations can cause too much of one protein, not enough of another – and alter your health forever. So now the work shifts to identifying and controlling individual genes. One has already been found: change that gene, and the risk of having ToF multiplies by nine.

Perhaps this research will one day lead to a pill or injection for expectant mothers  that will stabilize the child’s DNA and prevent the occurance of Tetralogy of Fallot!

Skateboard-move van de week. Wat is het überhaupt, een nollie hardflip of iets dergelijks?

Los van het feit of zinnen als “I shot a man in Reno, just to watch him die” nog geloofwaardig blijven is dit een zeer aardige cover van de 5-jarige Wesley, met zo’n naam misschien toch een jongetje. Wat het ook moge zijn, hij/zij heeft zijn/haar podiumpresentatie beter voor elkaar dan deze Foo Fighters-fan.

Ging Wel

Tof!

Kon Beter

Kut

xCesar! a.k.a ‘PipHetPepKonijn’

Om dit supernare filmpje meteen te doen vergeten even een feelgood-fragment. Als het zo kan, ga ik het ook overwegen.

Thanks Annewil.

De Tour-winnaar is inmiddels bekend, dus als volger zul je de laatste week zelf de spanning moeten creëren. Gelukkig is er nu Mag-ik-dat-zo-zeggen Bingo, waarmee je met de rebus erbij al twee redenen hebt om nog de Avondetappe te kijken. En het is nog helemaal gratis ook.

En haal meteen ook het bijpassende shirt. Wel iets minder gratis.